摘要
目的探讨合并甲状腺功能减退症(甲减)的老年肺炎病人的临床特征,以提高对肺炎合并甲减的临床认识和诊疗水平。方法回顾性研究我院2013年9月至2017年9月就诊住院的老年肺炎病人共286例,合并甲减的老年肺炎病人分为观察组,甲状腺功能正常老年肺炎病人为对照组,比较2组主要临床症状、影像学特征、低蛋白血症发生率、贫血发生率、血脂、B型脑钠肽(BNP)、血气及电解质水平、住院时间与死亡率等方面的差异。结果 2组病人咳嗽、咳痰及血清钾水平差异均无统计学意义(P>0.05)。观察组在气促、皮肤干燥、便秘、乏力等症状方面与对照组比较,差异均有统计学意义(P<0.05)。观察组病人的抑郁、低蛋白血症、贫血、高脂血症、低钠血症、浆膜腔积液、呼吸衰竭及心力衰竭等发生率显著高于对照组(P<0.01);观察组住院时间明显长于对照组,死亡率明显高于对照组,差异均有统计学意义(P<0.05)。结论对于老年肺炎病人,当其同时合并贫血、低蛋白血症、浆膜腔积液和按常规治疗效果欠佳的心功能不全时应警惕合并甲减可能。合并甲减的老年肺炎病人通常病情更重,死亡率更高,同时住院时间延长。
Objective To investigate the clinical characteristics of pneumonia complicated with hypothyroidism in the elderly. Methods A retrospective study was conducted in 286 elderly cases of pneumonia hospitalized in our hospital from September 2013 to September 2017. The patients were divided into observation group（ presenting with hypothyroidism and pneumonia） and control group（presenting with pneumonia）. The main clinical symptoms,imaging features,hypoproteinemia,anemia,serum lipids and B-type natriuretic peptide（ BNP）,blood gas and electrolyte levels,hospital stay and mortality were compared between the two groups. Results There were no significant differences in cough,expectoration and serum levels of potassium between the two groups（ P〉0. 05）. There were significant differences in symptoms of shortness of breath,dry skin,constipation and fatigue between the observation group and the control group（ P〈0. 05）. The incidence rates of depression,hypoproteinemia,anemia,hyperlipidemia,hyponatremia,serous effusion,respiratory failure and heart failure in the observation group were significantly higher than those in the control group（ P〈0. 01）; The hospitalization time of the observation group was significantly longer,and the mortality rate was significantly higher than that of the control group（ P〈0. 05）. Conclusions In the elderly patients with pneumonia,the possibility of hypothyroidism should be concerned when they present with anemia,hypoproteinemia,serous effusion and cardiac insufficiency,which are not well treated as usual. Elderly patients with pneumonia combined with hypothyroidism usually are more likely to have severe disease, higher mortality,and longer hospital stay.
作者
王中伟
万骁
宋亦
王勇
邱恭军
WANG Zhong-wei;WAN Xiao;SONG Yi;WANG Yong;QIU Gong-jun(the Second Department of Internal Medicine,Disabled Soldier Hospital in Hubei Province,Wuhan 430079,China)
出处
《实用老年医学》
CAS
2018年第9期859-861,共3页
Practical Geriatrics
